Studies on the role of viruses, bacteria, and M. pneumoniae as causes of lower respiratory tract infections in children

Loda, Frank A.; Clyde, Wallace A.; Glezen, W. Paul; Senior, Robert; Sheaffer, Charles I.; Denny, Floyd W.

doi:10.1016/s0022-3476(68)80305-1

Cited by 111 publications

(33 citation statements)

References 18 publications

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“…Streptococcus pneumoniae was the predominant organism in children who needed care as inpatients. Other bacteria occurred in very low frequencies in children, a finding which also agrees with those of other authors (3,14,15). Whereas only a very small number of children with pneumonia die in developed countries, the case-fatality rate in developing countries is 5-10 % in hospitals in large towns and over 10 % in some rural areas (16)(17)(18).…”

Section: Discussionsupporting

confidence: 87%

Prospective study on the etiology of community-acquired pneumonia in children and adults in Spain

Ausina

Coll

Sambeat

et al. 1988

Eur. J. Clin. Microbiol. Infect. Dis.

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The cause of primary pneumonia was diagnosed in 157 of 198 children and 165 of 207 adults seen as inpatients or outpatients in a 12-month period. In children Mycoplasma pneumoniae and pneumococcus were identified in 79 and 29 cases respectively. Twenty-nine of 53 cases of viral infection in children were caused by respiratory syncytial virus, two-thirds of the cases occurring in children under three years of age. No children died of pneumonia. In adults pneumococcus was the most common pathogen, accounting for 81 cases. The overall mortality in adults was 7.7%. A high mortality was found in patients with Haemophilus influenzae and other gram-negative bacilli infections, and in elderly patients with pneumococcal pneumonia. Coagglutination was more sensitive than counterimmunoelectrophoresis for the detection of pneumococcal antigen in respiratory samples (p less than 0.001). Counterimmunoelectrophoresis was the only useful technique for detection of pneumococcal antigen in urine specimens, concentration, overnight storage at 4 degrees C and specific staining significantly increasing positivity (p less than 0.001).

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Section: Discussionsupporting

confidence: 87%

Prospective study on the etiology of community-acquired pneumonia in children and adults in Spain

Ausina

Coll

Sambeat

et al. 1988

Eur. J. Clin. Microbiol. Infect. Dis.

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“…This is consistent with previous studies that reported very few cases of school-aged children requiring hospital evaluation for ADV. 2 As expected, the seasonal distribution showed a wintertime peak, but illness occurred yearround. 4,12,13 Although the majority of ADV infections resulted in respiratory illness, nearly 20% of the children had nonrespiratory diagnoses.…”

Section: Discussionsupporting

confidence: 65%

“…[1][2][3][4] It may produce upper or lower respiratory infection including bronchiolitis and pneumonia. 5 In addition, ADV infection is frequently associated with entities such as pharyngoconjunctival fever and epidemic conjunctivitis that are often diagnosed based on clinical examination alone.…”

mentioning

confidence: 99%

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

et al. 2004

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ABSTRACT. Background. Adenovirus (ADV) infections were difficult to diagnose in the past, and many infections were unrecognized. Direct fluorescent assay (DFA) for the rapid diagnosis of ADV infection, as part of a viral respiratory panel, became available at Primary Children's Medical Center (Salt Lake City, UT) in December 2000.Objective. To describe children with ADV infection diagnosed by DFA and viral culture and document the impact of rapid ADV testing on patient care.Methods. DFA testing for respiratory viruses including ADV was performed on nasal wash specimens with parallel viral culture. Chart review was performed for all ADV-positive patients identified from microbiology records between December 2000 and May 2002.Results. Of 1901 patients positive for respiratory viruses, 143 (7.5%) were ADV-positive by DFA or culture. The mean age of ADV-positive children was 23 months; 90% were <60 months old. Eighty percent were previously healthy, and 56% required admission with a mean length of stay of 3.4 days. The most common diagnoses included fever (31%), bronchiolitis (24%), and pneumonia (14%). Other conditions included suspected Kawasaki disease (KD) and hepatitis. Forty-six percent of ADV-positive children were given antibiotics at presentation, but only 2 (1.4%) had documented bacterial infection (one had Escherichia coli urinary tract infection and one had Moraxella catarrhalis bacteremia). Thirty-six percent of children had a change in management based on positive ADV DFA. In children with suspected KD (n ‫؍‬ 5), 100% had positive ADV DFA, and immune globulin was withheld in 4. One immunocompetent patient with fulminant liver failure received cidofovir treatment after a positive ADV DFA and recovered before liver transplant.Conclusions. ADV is a common infection in young children and often results in admission and unnecessary antibiotic therapy. Identifying ADV as the cause of illness can favorably impact care and in some instances may be life-saving. DFA testing for ADV should be considered for infants and children requiring admission for fever, respiratory illness, suspected KD, and hepatitis. Pediatrics 2004;113:e51-e56. URL: http://www.pediatrics. org/cgi/content/full/113/1/e51; adenovirus, rapid diagnosis, Kawasaki disease.ABBREVIATIONS. ADV, adenovirus; PCMC, Primary Children's Medical Center; DFA, direct fluorescent assay; ED, emergency department; RSV, respiratory syncytial virus; KD, Kawasaki disease; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; IVIG, intravenous immune globulin.A denovirus (ADV) is a well-known cause of respiratory illness in children. [1][2][3][4] It may produce upper or lower respiratory infection including bronchiolitis and pneumonia. 5 In addition, ADV infection is frequently associated with entities such as pharyngoconjunctival fever and epidemic conjunctivitis that are often diagnosed based on clinical examination alone. 6 Although most infections are self-limited, ADV can be associated with severe or lethal infection in both immunocompromised and healt...

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“…As mentioned above, M. pneumoniae is an important cause of pneumonia sufficiently severe to require hospitalization, especially in elderly persons (282,283,334). Several studies from the 1960s and 1970s indicate that M. pneumoniae may cause up to 5% of cases of bronchiolitis in young children (102,112,161,271). Chest auscultation may show scattered or localized rhonchi and expiratory wheezes.…”

Section: Vol 17 2004 M Pneumoniae As a Human Pathogen 707mentioning

confidence: 99%

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

2004

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Mycoplasma pneumoniae is a unique bacterium that does not always receive the attention it merits considering the number of illnesses it causes and the degree of morbidity associated with it in both children and adults. Serious infections requiring hospitalization, while rare, occur in both adults and children and may involve multiple organ systems. The severity of disease appears to be related to the degree to which the host immune response reacts to the infection. Extrapulmonary complications involving all of the major organ systems can occur in association with M. pneumoniae infection as a result of direct invasion and/or autoimmune response. The extrapulmonary manifestations are sometimes of greater severity and clinical importance than the primary respiratory infection. Evidence for this organism's contributory role in chronic lung conditions such as asthma is accumulating. Effective management of M. pneumoniae infections can usually be achieved with macrolides, tetracyclines, or fluoroquinolones. As more is learned about the pathogenesis and immune response elicited by M. pneumoniae, improvement in methods for diagnosis and prevention of disease due to this organism may occur

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Studies on the role of viruses, bacteria, and M. pneumoniae as causes of lower respiratory tract infections in children

Cited by 111 publications

References 18 publications

Prospective study on the etiology of community-acquired pneumonia in children and adults in Spain

Prospective study on the etiology of community-acquired pneumonia in children and adults in Spain

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

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